Q: What are the prospects for turn­ing Med­i­caid into block grants to the states?

Modern Healthcare - - NEWS -

Chip Kahn:

“Block-grant­ing is one of those poli­cies that peo­ple have a ro­mance for, par­tic­u­larly peo­ple on the right. And Med­i­caid block grants par­tic­u­larly are some­thing that many gov­er­nors, and some­times even Demo­cratic gov­er­nors, feel ro­man­tic to­ward be­cause im­plicit in it is that the fed­eral govern­ment would give them a pot of money.

“These gov­er­nors look at this and think it would al­low them to re­ally im­pact their health­care sys­tem and, frankly, con­trol their bud­gets. That’s the easy part. That’s the con­cep­tual part. The dilemma is the money. Show me the money.

“Med­i­caid is a com­pli­cated pro­gram. Not only is it byzan­tine in terms of how peo­ple qual­ify for it and who ac­tu­ally pro­vides care, it’s long-term care for the el­derly dis­abled; it’s the acute-care part of Med­i­caid; and then there’s the ACA ex­pan­sion.

“It’s even more com­pli­cated on the pay­ment side. No one could tell you right now with any ac­cu­racy what the real match rate is be­cause states have all these ad­just­ments and waivers. And on top of that, they have taxes and other ways to cap­ture Med­i­caid money.”

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